POS1586-HPR DOES DEVELOPING SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) MAKE A DIFFERENCE IN PATIENTS WITH UNDERLYING IDIOPATHIC THROMBOCYTOPENIC PURPURA (ITP)?
Authors: S. F. Skh Ali, F. Yahya, N. A. Mohd Zin, A. E. S. Mohamed Ridza, P. C. Bee
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> An estimate of 30–40% of patients with thrombocytopenia have idiopathic thrombocytopenic purpura (ITP) and thrombocytopenia is a common manifestation of systemic lupus erythematosus (SLE). Previous studies have shown the incidence of SLE in patients with ITP to be between 7% and 30% [1,2]. However, there are limited data on this especially in an Asian population. <h3>Objectives</h3> This study aims to investigate the incidence of SLE among Asian patients with underlying ITP and assess the differences between ITP patients who develop SLE and ITP patients who do not. <h3>Methods</h3> A retrospective review of electronic medical records of ITP patients from University of Malaya Medical Centre in Kuala Lumpur was conducted from January 2000 to June 2022. All adult patients with a diagnosis of ITP, verified by treating physicians, who fulfilled inclusion criteria within the time period were included into the study. Patients who subsequently developed SLE were identified. Patients with known SLE who developed secondary ITP after SLE diagnosis were excluded from the study. Data collected included age, sex, race/ethnicity, basic demographics, initial symptom presentation, comorbidities, and blood tests including hemoglobin and platelet levels upon initial presentation of ITP. <h3>Results</h3> Total of 181 ITP patients who fulfilled the inclusion criteria were recruited; 25 (13.8%) were males, 84 (46.4%) patients were of Chinese race and 30 (17.6%) were of Indian race. Eleven (6%) patients developed SLE with a mean age of ITP presentation at 35 years. There were no Indian race ITP patients who developed SLE in comparison to other races (p=0.01). Patients who developed SLE had lower haemoglobin at ITP diagnosis (8.0 [4.08] vs 11.8 [2.83] g/dL, p=0.005) and also lower levels of platelets upon diagnosis of ITP (3.0 [2.00-10.75] vs 24.0 [6.00-53.25] x109/L, p=0.025) in comparison to ITP patients who do not develop SLE. There were no differences in initial symptom presentation or comorbidities between the 2 groups. <h3>Conclusion</h3> Our study found that there are racial differences and differences in hematological presentation upon diagnosis of ITP in patients with ITP who subsequently develop SLE. However, further larger studies are required to further explore the differences, especially in the Asian population. <h3>References</h3> [1]Fayyaz A, Igoe A, Kurien BT, et al. Hematological manifestations of lupus. Lupus Science and Medicine 2015; 2, e000078 [2]Zhu F-X, Huang J-Y, Ye Z, et al. Risk of systemic lupus erythematosus in patient with idiopathic thrombocytopenic purpura: a population-based cohort study. Ann Rheum Dis. 17 March, 2020; 0: 1-7 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> siti fadillah skh ali: None declared, Fariz Yahya Speakers bureau: Pfizer, Novartis, Zuellig Pharma, Janssen, Abbvie and Gilead, Grant/research support from: Abbvie, Janssen, Gilead and Novartis, nurul aini mohd zin: None declared, anis elly suraya mohamed ridza: None declared, ping chong bee Speakers bureau: J&amp;J, Consultant of: BMS, ASTRA ZENECA and J&amp;J.